Cycling UK Forum

dbrunner wrote:For those of you interested in the BMJ article, here is a link:

http://www.bmj.com/cgi/content/full/321/7268/1055

This shows a marked decrease in head injuries during the period of the study, quite at odds with what an earlier poster claims.

I regard cyclists as a community of people who share a common interest, and if by posting some links to real papers (ie BMJ and NEJM), not hearsay, I can make one person re-consider their position on not wearing a helmet then I feel I will have done my bit.

As always, the choice is the individuals, but as a mathematician, I cannot let statistics be used to distort the 'facts' as percieved by some. If, after looking at the evidence an individual chooses to ignore it, then so be it, just do so from a position where the risks are quantified.

Dave

Again you need to read paper. AT no point is there any research to compare helmeted and non helmeted cyclists. The paper sates that

The number of serious head injuries among cyclists fell markedly during a period of increasing helmet use, suggesting that helmets offer protection

There is no allowanc for other factors - it is again assumed that ALL the decrease is due to helmets. Can we be sure there are no other factors?

As the paper itself states thatthe benefit of helmets is uncertain!

Case-control studies have shown the benefit of wearing helmets, though inadequate control for possible confounding factors means that this conclusion is uncertain.

dbrunner wrote:A little more research:

This is where it gets complicated.

Thompson and Rivara is one of the more famous pro-helmet studies, not least because it appears to have been discredited completely. The nail in its coffin was probably the demonstration, using its data, that helmets prevent 72% of injuries to parts of the body other than the head. However, the simple fact that none of us could really miss an 85%-effective safety measure ought to sound alarm bells - aren't we almost into too-good-to-be-true territory here?

For a more complete response, look at the summary by John Franklin. He is hardly an extremist - he wrote the UK advanced cycling manual, Cyclecraft, with RoSPA and DoT backing. His page on helmets includes "The effectiveness of cycle helmets" which addresses the above study.

In "Trends in cyclist casualties...", Franklin applies a method that several have used, which is to compare trends in cyclist and pedestrian casualties. These tend to follow similar patterns, but the introduction of (widespread) cycle helmets would be expected to be followed by a favourable comparative result for cyclists. Look for yourself.

In the first paper I mentioned, Franklin also comments on a more recent (official) assessment of the Australian result, concluding that head injuries post-enforcement may have decreased by less than levels of cycling - i.e. there were more head injuries per cyclist with helmets than before.

It was this kind of result that started people looking for explanations of why helmets could possibly increase risk, although IIRC the first warning came in a paper in the Journal of Product Liability in 1988.

Oh, and the BMJ has carried various papers on both sides, for example Wardlaw (2000).

All of which is why some of us are careful about jumping to conclusions.

lauriematt wrote:in the old days...

when bicycles were first being used...

were helmets about then??

When I first started cycling in the early 1970's, no such thing. Then the traffic was much lighter, esq on Sunday's. Then it all changed due to this stupid Sunday shopping.

Having spent last night reading through a number of reports and research papers, I would conclude that the overwhelming majority of them draw the conclusion that helmets prevent major head injury. Yes, you can pick out odd instances where the methodology is questionable and where there are other factors in play (same thing really) - but most do come to the conclusion that helmets prevent serious head injury.

Some include arguments about non-helmeted riders being more careful, but nowhere did I read that helmeted riders tended to take greater risks than those who don't. Others state that helmets don't prevent body trauma, well no, they are designed to protect the head.

Last December I had my first major accident in 40 years of cycling. A slippery road and my wheels went from under me in an instant; my head, or rather my helmet, hit the kerbstone on the inside of the roundabout. My face was a mess caused by my glasses embedding themselves in the skin, but that was about the worst of it. I believe that my helmet (cracked and discarded) prevented more serious head injury.

Anecdotal evidence I know, but can anyone give some counter evidence where wearing a helmet makes an injury worse? Yes there is some slight chance of increased neck injury in one of the papers, albeit by a very small percentage. But really, can wearing a helmet actually exacerbate a head injury?

Dave

I'm one of the no-helmet side, I had a very similar sounding accident to you dbr, except as i don't wear a helmet my first instinct is to protect my head, it meant I broke my collar bone.

But that's not why I'm writing I'm writing to say that the reason I don't wear a helmet is because I'm yet to find one that doesn't restrict my view. My cycling position can range from completely horizontal to completely vertical and most helmets dig when I'm horizontal... the rest slip when I'm sitting up... in both cases it's a restriction/distraction that I think won't increase my chance of making an injury worse, but it does increase the chance of me having an accident... as one of the pro-helmet sites said the best protection is prevention.

I wear a hi-vis jacket and currently have 5 lights on me/mybike and I'm going to get two of those reelights after seeing people talk about them here, I'm on a limited budget and think that the cost of a helmet is better spent on lights.

I have no problem with them being a legal part of cycling, as long as the prices dropped on them (at least) as a consequence. But at the moment they aren't and frankly I'm quite annoyed with the preachy nature of pro-helmet brigade.

No one has given any properly controlled statistics, because there aren't any!

If you want anecdotal evidence, I've had 5 crashes in my 25 years of cycling, no head injuries, therefore not wearing a helmet is safer

dbrunner wrote:Some include arguments about non-helmeted riders being more careful, but nowhere did I read that helmeted riders tended to take greater risks than those who don't.

if one group are more careful, then the other group have to be less careful by definition, surely?
anyway, as you've asked...it's time to trot out this old chestnut

http://www.bath.ac.uk/news/articles/arc ... 10906.html

keepontriking wrote:

dbrunner wrote:Ever seen a track rider without a helmet?

Dave

There were several on our local track on Sunday, all thoroughly enjoying themselves up and down the bankings.

All of them went home alive, too.

What track is that?

Maybe they all did get home alive but did any also crash?

I'm also annoyed with the preachy nature of the anti helmet brigade who keep going on about the idea that if cyclists are made to wear helmets we should make it compulsery for pedestrians because of the number of head injuries that they incur.
We can all point out various groups if we go along this path who should wear protective gear.

If someone doesn't want to wear a helmet that is their choice and I don't condemn or praise either.

hubgearfreak wrote:

dbrunner wrote:Some include arguments about non-helmeted riders being more careful, but nowhere did I read that helmeted riders tended to take greater risks than those who don't.

if one group are more careful, then the other group have to be less careful by definition, surely?
anyway, as you've asked...it's time to trot out this old chestnut

http://www.bath.ac.uk/news/articles/arc ... 10906.html

There is a difference between inceased caution on the one hand and 'normal' riding on the other. When I'm doing 40+ mph down a hill I have to assess the risks I am taking, do I think that by wearing a helmet I'm invulnerable? Of course not! But would I do the same whilst not wearing a helmet? No, I probably wouldn't so would arguably be at less risk, so by not wearing a helmet I'm theoretically a safer rider.

Re the second point.

Just because some drivers give less room to a cyclist with a helmet does not render the protection offered by a helmet invalid. This is an example of driver training needing a greater emphasis on awareness of vulnerable road users rather than glibly stating that you are more at risk by wearing a helmet.

An interesting debate, and other than the issues of freedom of choice, why are the anti-helmet lobby so against them? What would you do if they became compulsory?

Dave

ianr1950 wrote:

keepontriking wrote:

dbrunner wrote:Ever seen a track rider without a helmet?

Dave

All of them went home alive, too.

What track is that?

Maybe they all did get home alive but did any also crash?

I had a conversation with my father who said that child car seats are riduculous. "You never had them but you were OK". To which I replied, "yes but we didn't crash!"

Now I'm not for a moment suggesting that helmets are anywhere near as good as car child seat. In fact as far as these things go I think that they are pretty useless but I still wear one (but I do think that it is up to the individual or parents in the case of children to decide). However it is so easy for this sort of discussion to become derailed by people quoting folklaw or hearsay on either side of the debate.

The real trouble is that there isn't much in the way of real, reliable data available to support either side of the debate. So I will continue to wear my helmet and get my kids to wear them but don't think that people who don't are being any more or less sensible than me.

[color=darkred]An interesting debate, and other than the issues of freedom of choice, why are the anti-helmet lobby so against them? What would you do if they became compulsory?[/color]

I'm on sabbatical in NZ at present. NZ banned lidless cycling in 1994. I arranged a helmet exemption before arriving as I dislike riding with one.

NZ has seen a 29% reduction in distance travelled by bike since the law was brought in, a 51% reduction in trips made. As a proportion of all injuries sustained while cycling, head injuries have stayed pretty much the same despite an increase from 35%-90% in helmet wearing rates.

Nowadays there is private acknowledgement that the law has not worked. Police are not enforcing with such vigour ( I have not been stopped since arriving in January) and the H word is not mentioned in official literature. The publicity is all about cycling being a safe and healthy way of getting about. However previous publicity, especially at the time of the laws enactment stressed it's danger, with graphic images. There is a widespread belief that it's too dangerous to cycle, that it's something you need special clothing for. Cyclists are an 'out' group, beyond-the-pale.

Helmet wearing is a 'motherhood' issue here. No politician will touch it, so it will stay, despite it not reducing head injuries amongst cyclists.

The CTC is correct to be worried about a UK helmet law

I will ofcause continue to wear my helmet. In the past I've been stuck by a car 3 times, sidewards. One was so bad, I had severe delayed shock and started smoking again after packing up in the 20 years. I did however recover and thankfully packed in smoking again.

Last week I was nearly hit by a car, which came from nowhere. Luckly I had my helmet on.

dbrunner wrote:An interesting debate, and other than the issues of freedom of choice, why are the anti-helmet lobby so against them? What would you do if they became compulsory?

As mentioned previously, I think the restriction to my head movement and discomfort when wearing one is more likely to cause me to have an accident than save me from one.

Also that the cost is better spent on lights/brightclothing/cycling lessons.

If they were compulsory I would wear one (at least after I'd saved up the money to get a helmet), but I would probably cycle less. I also think there are lots of people who don't have helmets but do have bikes that would stop using their bikes because of lack of helmet. As cycling is much safer when more people are doing it this would have a bigger negative effect than any positive effect of helmets.

Asdace, I did just write a huge paragraph shooting down what you said, and then realised you are kidding! Doh! (I hope you are kidding!)

I'm not saying people who like to wear helmets shouldn't, just that I and anyone else that thinks they aren't a good idea should be allowed to carry on not wearing them.

dbrunner wrote:Just because some drivers give less room to a cyclist with a helmet does not render the protection offered by a helmet invalid. This is an example of driver training needing a greater emphasis on awareness of vulnerable road users rather than glibly stating that you are more at risk by wearing a helmet.

if wearing one increases my likeliness of being hit that is reason enough to not wear one in my book.
as for greater driver awareness, care & etc.. if they all behaved and obeyed the highway code then i wouldn't need one at all...i've never actually fell off, only been knocked off. and landed on my knees, hands & elbows

dbrunner wrote:Having spent last night reading through a number of reports and research papers, I would conclude that the overwhelming majority of them draw the conclusion that helmets prevent major head injury.

I put my own summary in the last thread on this topic, so I won't repeat it here.

But really, can wearing a helmet actually exacerbate a head injury?

It appears to be possible, yes.